Article
Sports with degenerative changes in the cervical spine - How high is the risk of a spinal contusion during a cervical trauma?
Sport mit degenerativen Veränderungen im Bereich der Halswirbelsäule – die Contusio Spinalis. Welche Gefahr besteht für das Rückenmark im Fall einer HWS-Distorsion?
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Published: | April 23, 2004 |
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Outline
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Objective
The number of middle age people who are regularly involved in sporting activities is growing rapidly. With a preexisting cervical spondylosis, and narrowing of the spinal canal they are at a high risk of receiving a major lesion of the spinal cord during a distortion of the cervical spine. Do we know enough to predict the risk of a spinal contusion? Would it be possible to develop recommendations for our patients?
Methods
We present an overview of the literature and discuss the anatomical and biomechanical aspects, epidemiology and treatment options. In addition, the case of a 35 year old man receiving a tetraplegia after a cervical distortion during snowboarding is reported.
Results
We provide a current standpoint concerning the biomechanical and anatomical risk factors for the spinal contusion. Predisposed levels are C3-6. Patients with a spinal canal <10mm have a very high risk, and patients with a spinal canal < 13mm, have a high risk of a lesion of the spinal cord. The different existing recommendations regarding therapy are presented. Operative treatment is reserved for cases with mass effect. MPSS infusions protocols like the Fehling (NASCIS 2001) for acute no penetration SCI are the standard treatment. The dosage depends on time gap between accident and first MPSS donation.
Conclusions
Patients with preexisting degenerative changes in the cervical spine have a high risk of getting a spinal contusion with a severe neurological deficit. We list the sporting activities with the highest numbers of spinal contusion.